Growing evidence suggests that colored light exposure can affect several brain functions in addit... more Growing evidence suggests that colored light exposure can affect several brain functions in addition to conscious visual perception. Blue as compared to green light has especially been shown to enhance alertness and vigilance, as well as cognitive functions. However, the role of light exposure in studies using non-invasive brain stimulation remains unclear. Here, we examined the impact of light on cognitive-emotional effects of prefrontal repetitive transcranial magnetic stimulation (rTMS). In a randomized within-subjects design, twenty participants (12 males, 26 ± 4 years) were exposed to blue or green light prior and concomitant to active or sham rTMS (1Hz, 15min, 110% of the resting motor threshold), applied over the right dorsolateral prefrontal cortex (DLPFC). In each condition, an emotional working memory task (EMOBACK) was presented pre- and post-intervention. Stimuli of the EMOBACK task were positive, negative and neutral words. Our results revealed valence-specific stimulat...
Although electroconvulsive therapy (ECT) is among the most effective treatment options for pharma... more Although electroconvulsive therapy (ECT) is among the most effective treatment options for pharmacoresistant major depressive disorder (MDD), some patients still remain refractory to standard ECT practise. Thus, there is a need for markers reliably predicting ECT non/response. In our study, we have taken a novel translational approach for discovering potential biomarkers for the prediction of ECT response. Our hypothesis was that the promoter methylation of p11, a multifunctional protein involved in both depressive-like states and antidepressant treatment responses, is differently regulated in ECT responders vs. nonresponders and thus be a putative biomarker of ECT response. The chronic mild stress model of MDD was adapted with the aim to obtain rats that are resistant to conventional antidepressant drugs (citalopram). Subsequently, electroconvulsive stimulation (ECS) was used to select responders and nonresponders, and compare p11 expression and promoter methylation. In the rat exp...
Approximately 1.2 million refugees have arrived in Germany since autumn 2014. They are often appr... more Approximately 1.2 million refugees have arrived in Germany since autumn 2014. They are often appraised as being a challenge for the German healthcare system because the acute need for healthcare support was large and appeared suddenly while at the same time resources were limited. This situation was previously unknown for a western European healthcare system, whereas it constitutes a typical challenge for nongovernmental organizations that are active in the field of emergency relief and development aid and that have developed a large number of successful intervention concepts. Of central importance in this context are the basic principles of equal rights, participation of those affected, the principle of nonmaleficence, the resource orientation instead of a deficit orientation as well as the need for integrated and stepped care models. These can serve as general principles not only in the setting of development aid in crisis areas worldwide but also in the health services provided t...
Empathy is highly relevant for social behavior and can be verbally expressed by voicing sympathy ... more Empathy is highly relevant for social behavior and can be verbally expressed by voicing sympathy and concern (emotional empathy) as well as by paraphrasing or stating that one can mentally reconstruct and understand another person's thoughts and feelings (cognitive empathy). In this study, we investigated the emotional effects and neural correlates of receiving empathic social responses after negative performance feedback and compared the effects of emotionally vs. cognitively empathic comments. 20 participants (10 male) underwent functional magnetic resonance imaging while receiving negative performance feedback for a cognitive task. Performance feedback was followed by verbal comments either expressing cognitive and emotional empathy or demonstrating a lack of empathy. Empathic comments in general led to less negative self-reported feelings and calmer breathing. At the neural level, empathic comments induced activity in regions associated with social cognition and emotion proc...
BackgroundVagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequenc... more BackgroundVagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression.MethodAn open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically.ResultsThe baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (⩾50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after resp...
Background Transcranial Direct Current Stimulation (tDCS) has been associated with improvement in... more Background Transcranial Direct Current Stimulation (tDCS) has been associated with improvement in affective disorders. However, little is known about the influence oft tDCS on treatment-resistant schizophrenia with predominant negative symptoms. In this case study we looked on the effects of prefrontal tDCS on schizophrenic symptoms and functional MRI connectivity (fcMRI) changes. Methods The 19-year old patient was diagnosed with paranoid schizophrenia (DSM-IV: 295.30). He was treated with olanzapine 20 mg/day over 8 weeks without relevant psychopathological changes of paranoia and avolition. The patient underwent 10 tDCS sessions with the anode over the left DLPFC and the cathode over the right supraorbital region using a stimulation intensity of 2 mA and a stimulation duration of 20 min (Eldith Stimulator, electrode size: 7 times 5 cm2).The following clinical ratings and tests were used at baseline, after 5 and 10 tDCS treatments: PANSS, SANS, CDSS, SOPT, TMT. fcMRI was recorded at baseline, immediately after one tDCS sesion and after 10 days of tDCS (3.0 Tesla standard clinical scanner (Achieva TX, Philips Healthcare). Results After two weeks of tDCS treatment there was a considerable change in psychopathology. PANSS total score declined by 29%, SANS total score declined by 28%, Subjective feelings of depression (CDSS) were reduced by 82%. There was a pronounced improvement in the Trail Making Test (TMT) and the Self Ordered Pointing Task (SOPT). The fcMRI in the subgenual region was significantly reduced immediately after tDCS stimulation and this effect was even more extended after 10 days of tDCS (p Conclusion The significant fcMRI changes are consistent to the clinical and cognitive improvements of the patient. tDCS of the dorsolateral prefrontal cortex seems to be a promising tool for the treatment of negative symptoms in schizophrenia. However, larger studies are needed for investigating the role of the specific effects of tDCS on the symptom variety in schizophrenia. Download : Download high-res image (153KB) Download : Download full-size image
Journal für Neurologie, Neurochirurgie und Psychiatrie, Nov 14, 2007
Depressionen sind medizinisch sowie gesundheitsökonomisch hochrelevante Erkrankungen, deren thera... more Depressionen sind medizinisch sowie gesundheitsökonomisch hochrelevante Erkrankungen, deren therapieresistente Verläufe zunehmend mit sogenannten antidepressiven Stimulationsverfahren behandelt werden. Zu diesen gehört die Vagusnervstimulation (VNS), die in den vergangenen Jahren im Rahmen mehrerer klinischer Studien erprobt wurde. Zum gegenwärtigen Zeitpunkt ist die Evidenz für eine genügende Wirksamkeit zur Akutbehandlung noch nicht ausreichend. Allerdings scheint ...
Growing evidence suggests that colored light exposure can affect several brain functions in addit... more Growing evidence suggests that colored light exposure can affect several brain functions in addition to conscious visual perception. Blue as compared to green light has especially been shown to enhance alertness and vigilance, as well as cognitive functions. However, the role of light exposure in studies using non-invasive brain stimulation remains unclear. Here, we examined the impact of light on cognitive-emotional effects of prefrontal repetitive transcranial magnetic stimulation (rTMS). In a randomized within-subjects design, twenty participants (12 males, 26 ± 4 years) were exposed to blue or green light prior and concomitant to active or sham rTMS (1Hz, 15min, 110% of the resting motor threshold), applied over the right dorsolateral prefrontal cortex (DLPFC). In each condition, an emotional working memory task (EMOBACK) was presented pre- and post-intervention. Stimuli of the EMOBACK task were positive, negative and neutral words. Our results revealed valence-specific stimulat...
Although electroconvulsive therapy (ECT) is among the most effective treatment options for pharma... more Although electroconvulsive therapy (ECT) is among the most effective treatment options for pharmacoresistant major depressive disorder (MDD), some patients still remain refractory to standard ECT practise. Thus, there is a need for markers reliably predicting ECT non/response. In our study, we have taken a novel translational approach for discovering potential biomarkers for the prediction of ECT response. Our hypothesis was that the promoter methylation of p11, a multifunctional protein involved in both depressive-like states and antidepressant treatment responses, is differently regulated in ECT responders vs. nonresponders and thus be a putative biomarker of ECT response. The chronic mild stress model of MDD was adapted with the aim to obtain rats that are resistant to conventional antidepressant drugs (citalopram). Subsequently, electroconvulsive stimulation (ECS) was used to select responders and nonresponders, and compare p11 expression and promoter methylation. In the rat exp...
Approximately 1.2 million refugees have arrived in Germany since autumn 2014. They are often appr... more Approximately 1.2 million refugees have arrived in Germany since autumn 2014. They are often appraised as being a challenge for the German healthcare system because the acute need for healthcare support was large and appeared suddenly while at the same time resources were limited. This situation was previously unknown for a western European healthcare system, whereas it constitutes a typical challenge for nongovernmental organizations that are active in the field of emergency relief and development aid and that have developed a large number of successful intervention concepts. Of central importance in this context are the basic principles of equal rights, participation of those affected, the principle of nonmaleficence, the resource orientation instead of a deficit orientation as well as the need for integrated and stepped care models. These can serve as general principles not only in the setting of development aid in crisis areas worldwide but also in the health services provided t...
Empathy is highly relevant for social behavior and can be verbally expressed by voicing sympathy ... more Empathy is highly relevant for social behavior and can be verbally expressed by voicing sympathy and concern (emotional empathy) as well as by paraphrasing or stating that one can mentally reconstruct and understand another person's thoughts and feelings (cognitive empathy). In this study, we investigated the emotional effects and neural correlates of receiving empathic social responses after negative performance feedback and compared the effects of emotionally vs. cognitively empathic comments. 20 participants (10 male) underwent functional magnetic resonance imaging while receiving negative performance feedback for a cognitive task. Performance feedback was followed by verbal comments either expressing cognitive and emotional empathy or demonstrating a lack of empathy. Empathic comments in general led to less negative self-reported feelings and calmer breathing. At the neural level, empathic comments induced activity in regions associated with social cognition and emotion proc...
BackgroundVagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequenc... more BackgroundVagus nerve stimulation (VNS) therapy is associated with a decrease in seizure frequency in partial-onset seizure patients. Initial trials suggest that it may be an effective treatment, with few side-effects, for intractable depression.MethodAn open, uncontrolled European multi-centre study (D03) of VNS therapy was conducted, in addition to stable pharmacotherapy, in 74 patients with treatment-resistant depression (TRD). Treatment remained unchanged for the first 3 months; in the subsequent 9 months, medications and VNS dosing parameters were altered as indicated clinically.ResultsThe baseline 28-item Hamilton Depression Rating Scale (HAMD-28) score averaged 34. After 3 months of VNS, response rates (⩾50% reduction in baseline scores) reached 37% and remission rates (HAMD-28 score <10) 17%. Response rates increased to 53% after 1 year of VNS, and remission rates reached 33%. Response was defined as sustained if no relapse occurred during the first year of VNS after resp...
Background Transcranial Direct Current Stimulation (tDCS) has been associated with improvement in... more Background Transcranial Direct Current Stimulation (tDCS) has been associated with improvement in affective disorders. However, little is known about the influence oft tDCS on treatment-resistant schizophrenia with predominant negative symptoms. In this case study we looked on the effects of prefrontal tDCS on schizophrenic symptoms and functional MRI connectivity (fcMRI) changes. Methods The 19-year old patient was diagnosed with paranoid schizophrenia (DSM-IV: 295.30). He was treated with olanzapine 20 mg/day over 8 weeks without relevant psychopathological changes of paranoia and avolition. The patient underwent 10 tDCS sessions with the anode over the left DLPFC and the cathode over the right supraorbital region using a stimulation intensity of 2 mA and a stimulation duration of 20 min (Eldith Stimulator, electrode size: 7 times 5 cm2).The following clinical ratings and tests were used at baseline, after 5 and 10 tDCS treatments: PANSS, SANS, CDSS, SOPT, TMT. fcMRI was recorded at baseline, immediately after one tDCS sesion and after 10 days of tDCS (3.0 Tesla standard clinical scanner (Achieva TX, Philips Healthcare). Results After two weeks of tDCS treatment there was a considerable change in psychopathology. PANSS total score declined by 29%, SANS total score declined by 28%, Subjective feelings of depression (CDSS) were reduced by 82%. There was a pronounced improvement in the Trail Making Test (TMT) and the Self Ordered Pointing Task (SOPT). The fcMRI in the subgenual region was significantly reduced immediately after tDCS stimulation and this effect was even more extended after 10 days of tDCS (p Conclusion The significant fcMRI changes are consistent to the clinical and cognitive improvements of the patient. tDCS of the dorsolateral prefrontal cortex seems to be a promising tool for the treatment of negative symptoms in schizophrenia. However, larger studies are needed for investigating the role of the specific effects of tDCS on the symptom variety in schizophrenia. Download : Download high-res image (153KB) Download : Download full-size image
Journal für Neurologie, Neurochirurgie und Psychiatrie, Nov 14, 2007
Depressionen sind medizinisch sowie gesundheitsökonomisch hochrelevante Erkrankungen, deren thera... more Depressionen sind medizinisch sowie gesundheitsökonomisch hochrelevante Erkrankungen, deren therapieresistente Verläufe zunehmend mit sogenannten antidepressiven Stimulationsverfahren behandelt werden. Zu diesen gehört die Vagusnervstimulation (VNS), die in den vergangenen Jahren im Rahmen mehrerer klinischer Studien erprobt wurde. Zum gegenwärtigen Zeitpunkt ist die Evidenz für eine genügende Wirksamkeit zur Akutbehandlung noch nicht ausreichend. Allerdings scheint ...
Background: Converging evidence suggests that well-being plays an important role in promoting and... more Background: Converging evidence suggests that well-being plays an important role in promoting and maintaining mental health across the life span. It has been shown that well-being has a considerable heritable component, but little is known about the specific genes involved. Methods: In this study, we investigated a healthy sample (N = 298) that was genotyped for the serotonin transporter-linked polymorphic region (5-HTTLPR). We hypothesized that 5-HTTLPR gene variation would influence well-being, and additionally investigated interaction effects with age and the environmental influence of early life stress (ELS). Results: Using multiple regression, our results showed a significant three-way interaction between genotype, ELS, and age. Exploration of this interaction showed that young subjects had decreased levels of well-being if they were exposed to ELS and homozygous for the short variant of 5-HTTLPR. This relationship was reversed in old age: subjects that were exposed to ELS and carried the long variant of 5-HTTLPR had decreased levels of well-being. Conclusion: Our results indicate that genetic and environmental factors have joint effects on well-being that are susceptible to profound changes across the life span.
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Papers by Malek Bajbouj
Methods: In this study, we investigated a healthy sample (N = 298) that was genotyped for the serotonin transporter-linked polymorphic region (5-HTTLPR). We hypothesized that 5-HTTLPR gene variation would influence well-being, and additionally investigated interaction effects with age and the environmental influence of early life stress (ELS).
Results: Using multiple regression, our results showed a significant three-way interaction between genotype, ELS, and age. Exploration of this interaction showed that young subjects had decreased levels of well-being if they were exposed to ELS and homozygous for the short variant of 5-HTTLPR. This relationship was reversed in old age: subjects that were exposed to ELS and carried the long variant of 5-HTTLPR had decreased levels of well-being.
Conclusion: Our results indicate that genetic and environmental factors have joint effects on well-being that are susceptible to profound changes across the life span.